Right vertical infra axillary thoracotomy: Anatomically and cosmetically a superior approach for repair of simple congenital cardiac defects

Rajesh Kishan Rao, Girish B, Jayaprakash, Nikhil S

Pdf Page Numbers :- 49-52

Rajesh Kishan Rao^1,*, Girish B¹, Jayaprakash¹ and Nikhil S¹

¹Department of Cardiothoracic Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore-560 069, Karnataka, India

*Corresponding author: Dr. Rajesh Kishan Rao, MS., MCh., Associate Professor, Department of Cardiothoracic Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research. Bannergatta Road, Jayanagar 9^th block, Bangalore-560069, Karanataka, India. Mobile: +9198869 64031; Fax: 080-22977422; Email : merajesh14@yahoo.com

Received 25 January 2017; Revised 16 March 2017; Accepted 23 March 2017; Published 31 March 2017

Citation: Rao RK, Girish B, Jayaprakash, Nikhil S. Right vertical infra axillary thoracotomy: Anatomically and cosmetically a superior approach for repair of simple congenital cardiac defects. J Med Sci Res. 2017; 5(2):49-52. DOI: http://dx.doi.org/10.17727/JMSR.2017/5-10

Copyright: © 2017 Rao RK et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Objective: To evaluate the safety of Right Vertical Infra Axillary Thoracotomy (RVIAT) for the repair of simple congenital cardiac defects in adolescent girls.

Method: Between February 2016 and July 2016 we performed intracardiac repair for ostium secundum defects in 16 adolescent girls through RVIAT. Median age and weight was 14.5yrs and 33.5Kg respectively. All patients were approached through right vertical infra-axillary incision and right plural cavity was entered through third intercostal space. Cardio Pulmonary Bypass (CPB) was instituted with aortic and bicaval cannulation. Regular aortic cross clamp was used and cardioplegic arrest was employed in all the patients. In nine patients the defect was closed with autologous pericardium and in seven patients direct closure was done.

Results: Operative time, CPB and clamp time were slightly longer in our study repair was safely performed with central cannulation in all the patients. There was no conversion to another approach. At fifth month follow up all were in sinus rhythm with no residual defects. There was no deformity of the thorax or asymmetry of the breast.

Conclusion: RVIAT can be safely performed for repair of simple congenital cardiac defects without compromising the quality of repair. This approach does not interfere with growth of breast tissue, does not cause deformity of the thorax and can be performed with regular instruments and cannulae.

Keywords: RVIAT; atrial septal defects; anterolateral thoracotomy